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Iron deficiency anemia  causing blue skin under the eyes. If there is a shortage of iron in the body, oxygen cannot be properly transported by the blood. Hemoglobin is the oxygen transporting component in the blood, moving oxygen from the lungs to the cells where it is released for normal cell metabolism.
âAnemia resulting from low levels of iron can lead to inadequate oxygen in the blood, which causes the skin and tissues to become pale, particularly the tissues under the nails,â says Shilpi Agarwal, M.D., a board-certified family medicine and integrative and holistic medicine physician in Los Angeles.